Seasonal variations in the onset of ulcerative colitis

Uppsala University Hospital, Uppsala, Uppsala, Sweden
Gut (Impact Factor: 14.66). 04/1996; 38(3):376-8. DOI: 10.1136/gut.38.3.376
Source: PubMed


Several retrospective studies have reported seasonal variations in the relapse of ulcerative colitis, and two studies have found seasonality in the onset of ulcerative colitis, with a peak from August to January. This study was designed to investigate possible seasonal variations of onset of ulcerative colitis (UC) and Crohn's disease (CD). Patients with symptoms of one year or less were recruited from a prospective study of the incidence of inflammatory bowel disease, and the onset of symptoms was recorded month by month for four consecutive years. A total of 420 patients with UC and 142 patients with CD were included. There was monthly seasonality (p = 0.028) in symptomatic onset in December and January for UC but not for CD. It was found that environmental agents with known seasonality can be of importance for the seasonal variations of disease onset in UC.

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Available from: Morten H Vatn, May 14, 2014
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    • "As previously noted by our group, the endoscopic diagnosis date should not be used to assess the occurrence of seasonal variation in a study that aimed to investigate the etiopathogenesis of the disease (Basaranoglu et al., 2006; Basaranoglu, 2006). Although few studies designed according to the above-mentioned criteria reported a seasonal variation in IBD, prior limited results are conflicting and the presence of a seasonal pattern in patients with IBD remains unestablished (Moum et al., 1996; Aratari et al., 2006). "
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    ABSTRACT: Environmental factors are believed to trigger the onset of Inflammatory bowel disease (IBD). We aimed to evaluate the seasonal variation in the onset of symptoms in patients with IBD and health care seeking behaviour. 282 patients were chosen from the charts. Demographic features, the month and the age at the onset of presenting symptoms and delayed diagnosis term for each patient were analyzed. Cumulative monthly averages analysed by Kruskal Wallis test and Roger's test. Of the 282 patients with IBD, 181 were male (64%). Mean age was 40.1±14.7 years (median: 38, range: 14 to 79 years). The seasonal pattern showed peak in March with 57% and the lowest point in November with 36% (p <0.05). The delayed diagnosis term was 3.0 ± 2.3 months in males vs 3.2 ± 3.2 months in females (p >0.05). The seasonal pattern was not influenced by both genders and by age groups in patients with IBD or UC or CD (p >0.05). We investigated the etiologic environment of IBD and found an interaction between the etiopathogenesis of IBD and environmental risk factors. There was a delay in IBD, but no difference on the health care seeking behaviour between males and females.
    Full-text · Article · Jan 2013 · African journal of microbiology research
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    • "However, other studies have reported no seasonal variations in the onset of symptoms in UC [16]. The only prospective study addressing seasonality in the onset of symptoms was performed in Norway [17]: symptomatic onset of UC occurred more frequently in December and January but no seasonality was observed in CD. "
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    ABSTRACT: Seasonal variations in onset of symptoms have been reported in ulcerative colitis but not in Crohn's disease. AIM.: To investigate whether our inflammatory bowel diseases patients presented seasonal variations in onset of symptoms. Patients with a diagnosis of inflammatory bowel diseases established between 1995 and May 2004, and consecutively observed from June 2003 to May 2004, were included in the study. Onset of symptoms (year, season and month) was recorded. Expected onsets with a uniform distribution during the year were calculated and compared to observed onsets. Statistical analysis: chi-square test, odds ratio (95% confidence interval). Overall 425 inflammatory bowel diseases patients were enrolled. Onset of symptoms (year and season) was established in 353/425 patients (83%; 150 Crohn's disease; 203 ulcerative colitis). Onset of symptoms in inflammatory bowel diseases patients as a whole occurred more frequently in spring-summer compared to autumn-winter (odds ratio 1.39; 95% confidence interval 1.03-1.87; p<0.03). This variation was observed in Crohn's disease (odds ratio 1.59; 95% confidence interval 1.00-2.51; p<0.05) and a similar trend, although not significant, was observed in ulcerative colitis (odds ratio 1.27; 95% confidence interval 0.86-1.88; p=0.27). These data indicate that onset of Crohn's disease symptoms occurred more frequently during spring-summer. A similar trend was observed in ulcerative colitis. Environmental factors, such as associated infections, smoking, use of drugs and seasonal changes in immune function may be responsible for triggering the clinical onset of inflammatory bowel diseases.
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    ABSTRACT: Crohn's disease and ulcerative colitis are idiopathic infl ammatory bowel disorders. In this paper, we discuss how environmental factors (eg, geography, cigarette smoking, sanitation and hygiene), infectious microbes, ethnic origin, genetic susceptibility, and a dysregulated immune system can result in mucosal infl ammation. After describing the symbiotic interaction of the commensal microbiota with the host, oral tolerance, epithelial barrier function, antigen recognition, and immunoregulation by the innate and adaptive immune system, we examine the initiating and perpetuating events of mucosal infl ammation. We pay special attention to pattern-recognition receptors, such as toll-like receptors and nucleotide-binding-oligomerisation-domains (NOD), NOD-like receptors and their mutual interaction on epithelial cells and antigen-presenting cells. We also discuss the important role of dendritic cells in directing tolerance and immunity by modulation of subpopulations of eff ector T cells, regulatory T cells, Th17 cells, natural killer T cells, natural killer cells, and monocyte-macrophages in mucosal infl ammation. Implications for novel therapies, which are discussed in detail in the second paper in this Series, are covered briefl y.
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